Karin Emtell Iwarsson

Unintended pregnancies negatively impact women’s health and autonomy, contributing to societal costs and inequality, not least in young women. Emergency contraceptive pills (ECP) (“morning after pill”) are widely used to prevent unwanted pregnancy after unprotected sexual intercourse. Swedish women are increasingly reluctant to use regular contraception, leading to higher use of ECPs, despite their lower efficacy. Our recent international trial suggests that combining ECP with a cyclooxygenase (COX) inhibitor may improve its effectiveness. This feasibility study aims to assess the potential for a future clinical trial and how a similar combination treatment could be implemented in Swedish youth clinics. A retrospective data analysis and prospective registration will provide an overview of patient volume and age distribution. Further, by interviewing youths and midwives we will explore views on recruitment, logistics, and acceptability. If feasible, a pilot study will follow, testing protocol adherence, treatment experience and evaluation of possible side-effects and adverse events. The goal is a multicenter, double-blind, randomized placebo-controlled trial at youth clinics in at least five regions in Sweden, with potential expansion to international settings involving women of all reproductive ages. If the combination treatment proves more effective, the societal benefit would be significant - for women in general and young women in particular, in Sweden as well as globally.